Venezuela’s socialist government fired Antonieta Caporale, its sixteenth Minister of Health since dictator Hugo Chávez took power, after only four months on the job. The dismissal followed the publication of alarming national health statistics that showed a steep increase in infant and maternal mortality rates in the past year.

The government announced Caporale’s dismissal on Thursday in the Official Gazette, a government document that records the happenings within the federal government.

Venezuela’s Vice President Tareck El Aissami, a U.S.-designated “drug kingpin,” announced the health minister’s departure on Twitter, deviating from the tradition of holding an official ceremony to announce a change of the guard in the nation’s Cabinet.

CNN en Español notes that the government published the Gazette, including her dismissal, three days after the release of a Ministry of Health national public health evaluation that painted the socialist health care system in an embarrassing light, showing a precipitous decline in key public health indicators and a boom in diseases pre-socialist Venezuela had eradicated.

The Ministry of Health released annual reports for decades before dictator Nicolás Maduro took over. By the time the new document surfaced last week, the ministry had not published such official statistics in nearly two years.

The document noted that 11,466 children between the ages of 0 and 1 had died nationwide in 2016 and that maternal mortality rates – the death of a woman between conception and 42 days after childbirth – had increased by 65 percent in the past year. Diseases like diphtheria, which Venezuela had completely eradicated before socialism, have returned, and cases of malaria increased by 76 percent.

The publication of these statistics shocked the international community but garnered Caporale herself the praise of international humanitarian institutions. A UNICEF statement, for example, praised the move last week: “The publication of the data by the Ministry of Health is a crucial step in addressing health challenges in Venezuela. (It) provides stark evidence of the impact of the prolonged crisis on women and children in the country.”

The Maduro government has replaced Caporale with Luis Salerfi López Chejade, a pharmacist by trade who held the minister of health position in Aragua state, where El Aissami served as longtime governor before taking up the vice presidency. Caporale, in contrast, is a gynecologist and practiced medicine in hospitals before assuming the position with no political background.

The Venezuelan opposition has condemned the move. Opposition leader Jesús Torrealba noted on Twitter: “with the removal of Antonieta Caporale, the Chávez-Maduro disaster has appointed 16 Ministers of Health in the 18 years of non-government. Criminal piracy.”

The Venezuelan medical system has not been functional at any point in Maduro’s tenure, which began in 2013 following Chávez’s death. A 2013 Associated Press report condemned the government for rigidly controlling the socialist universal health care system, imposing price and currency controls that made it nearly impossible for hospitals to remain fully stocked and exacerbating the astronomical wait times Venezuelans experienced scheduling a doctor’s appointment.

By 2017, over 13,000 Venezuelan doctors had abandoned the country, according to CNN, and Venezuelan pharmacies lacked access to 85 percent of the medications listed by the World Health Organization as necessary to maintain a functioning health care system.

In March 2017, Maduro delivered a speech demanding the United Nations help Venezuela buy medications, after years of denying that Venezuela’s health care system, largely managed by allies from communist Cuba, was collapsing. Shortly before this demand, Maduro put full control of the nation’s medical supplies in the hands of Defense Minister Vladimir Padrino López and the nation’s military “to guarantee that these medicines and supplies get to the patient efficiently and are neatly distributed and assigned,” according to Padrino López.

Much like the nation’s food supply, also in the hands of the government, corruption and mismanagement have plagued this distribution mechanism as well.